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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1536122
This article is part of the Research TopicApplication of Emerging Technologies in the Diagnosis and Treatment of Patients with Brain Tumors: New Frontiers in Imaging for Neuro-oncologyView all 9 articles
The Diagnostic Value of Advanced Tracer Kinetic Models in Evaluating High Grade Gliomas Recurrence and Treatment Response Using Dynamic Contrast-Enhanced MRI
Provisionally accepted
Jianan Zhou1,2,3
Zujun Hou4
Xiuqi Guan5
Zhengyang Zhu2,3
Wang Han6Cong Wang7Wei Luo5
Chuanshuai Tian1,2,3
Huiquan Yang2,3
Meiping Ye2,3
Sixuan Chen2,3
Xin Zhang1,2,3*
Bing Zhang1,2,3- 1Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Liaoning Province, China
- 2Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- 3Medical Imaging Center, Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing, China
- 4Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- 5FISCA Healthcare Co., Ltd., Nanjing, China
- 6Nanjing center for Applied Mathematics, Nanjing, China
- 7School of Electronics and Information Engineering, Suzhou Vocational University, Suzhou, China
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The purpose of this study was to investigate the diagnostic value of advanced tracer kinetic models (TKMs) in differentiating HGGs recurrence and treatment response.Methods: A total of 52 HGGs were included. DCE images were analyzed using the following TKMs: distributed parameter (DP), tissue homogeneity (TH), Brix's two-compartment (Brix) and extended-Tofts model (ETM), yielding the following parameters: cerebral blood flow (CBF), mean transit time (MTT), plasma volume (Vp), extravascular volume (Ve), vascular permeability (PS) and first-pass extraction ratio (E) in advanced TKMs (DP, TH and Brix); K trans , Ve, Vp and Kep in ETM. Two delineation methods were conducted (routine scans and parameter heat maps). The differences between two MRI scanners were compared. Mann-Whitney U test was used to assess the difference of parameter values. Diagnostic performance was assessed using the method of the receiver operating characteristic (ROC) curves, with the areas under the ROC curves (AUC) to determine the discriminating power of DCE parameters between recurrent tumor group and treatment response group ROC curves. P<0.05 indicates statistical significance.The difference on the normalized kinetic parameter value (with respect to contralateral normal-appearing white matter) between two MRI scanners was statistically insignificant (P＞0.05). MTT and Vp of advanced TKMs were higher in recurrent than in treatment response group (P＜0.05). For ROI delineated on parameter heat maps, MTT(DP) attained the best performance with AUC 0.88, followed by MTT(TH) and Vp (DP, Brix) with AUCs around 0.80 (0.81, 0.80, 0.79 respectively). The best performance in ETM was Vp (AUC = 0.73).MTT (DP, TH), and Vp (DP, Brix) could be potential quantitative imaging biomarkers in distinguishing recurrence and treatment response in HGGs.
Keywords: high grade glioma1, dynamic contrast-enhanced2, tracer kinetic model3, treatment response4, recurrence5
Received: 28 Nov 2024; Accepted: 25 Mar 2025.
Copyright: © 2025 Zhou, Hou, Guan, Zhu, Han, Wang, Luo, Tian, Yang, Ye, Chen, Zhang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xin Zhang, Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Liaoning Province, China
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